Efek Pemberian Pre-emptive Fentanyl 25 μg terhadap Kejadian Batuk Setelah Bolus Fentanyl 2 μg/kg IV (Fentanyl Induced Cough)
ABSTRACT

Background : Fentanyl is a potent synthetic opioid which has so many advantages, that makes fentanyl frequently used as premedication and induction agent in general anesthesia. Fentanyl induce cough (FIC) is an unexpected event in particular surgery which makes FIC should be avoided. So many researches had been done but show inefficient results. This research tried to give pre-emptive fentanyl dose to decrease incident of FIC.

Objectives: To analyze effect of preemptive fentanyl 25 μg intravenously related to fentanyl induce cough after fentanyl 2 μg/kgBW given intravenously.

Methods: Forty patients which had been scheduled for surgery were chosen randomly in this research. They were splited into two groups, the first one (20 patients) obtained 0,5 mL normal saline injection intravenously followed by fentanyl 2 μg/kgBW in 2 second. And the other got fentanyl 25 μg before fentanyl induction. Mann-Whitney and Spearman test was performed to compare and determine both groups.

Results: Pre-emptive fentanyl showed significant result (p=0,183) in cough incident compared to the group which had obtained normal saline only but had negative correlation in both groups related to cough and insignificant (p=0,08). In level of cough, the result showed significant (p=0,043), but also had negative correlation (- 0,326) in significant value (p=0,04).

Conclusion: Pre-emptive fentanyl 25 μg might decrease the FIC incidence but statistically insignificant. In the future, the following research must show better results of precise preemptive fentanyl dose and the alternative methods in order to decrease FIC incidence.

Keywords : pre-emptive fentanyl, cough, fentanyl induce cough
ABSTRAK

Latar belakang: Fentanyl merupakan opioid sintetik yang poten, dengan berbagai kelebihannya sehingga fentanyl dijadikan pilihan utama agen premedikasi dan induksi anestesi umum. Kejadian batuk setelah pemberian bolus fentanyl intravena/ fentanyl induce cough (FIC) merupakan sesuatu yang tidak diharapkan pada kasus pembedahan tertentu sehingga pencegahan FIC haruslah dilakukan. Beberapa penelitian telah dilakukan namun kurang efisien, oleh karenanya pada penelitian ini dilakukan pemberian pre-emptive fentanyl dosis 25 μg untuk menurunkan FIC.

Tujuan: Mengetahui efek pemberian pre-emptive fentanyl 25 μg intravena terhadap insiden batuk setelah bolus fentanyl 2 μg/kgBB intravena.

Metode: Empat puluh pasien yang menjalani operasi dengan anestesi umum dipilih secara acak untuk diikutkan dalam penelitian. Dibagi menjadi dua kelompok, kelompok pertama (20 pasien) mendapat injeksi intravena normal salin 0,5 ml dan diikuti fentanyl 2 μg/kgBB dalam 2 detik, dan kelompok sisanya mendapatkan injeksi intravena fentanyl 25 μg sebelum fentanyl induksi. Digunakan tes Mann-Whitney dan uji korelasi Spearman untuk membandingkan dan menilai hubungan variabel.

Hasil: Pemberian pre-emptive fentanyl menunjukkan nilai signifikansi 0.183 pada timbulnya batuk dibandingkan kelompok yang mendapat normal saline namun berkorelasi negatif. Hubungan insiden batuk diantara kedua kelompok bernilai tidak signifikan (p=0,08). Dari derajat batuknya, berbeda signifikan (p=0,043), dengan nilai koefisien korelasi negatif (-0,326) dan nilai yang signifikan (p=0,04).

Simpulan : Pemberian pre-emptive fentanyl 25 μg dapat menurunkan insiden FIC namun secara statistik tidak bermakna.Perlu penelitian selanjutnya untuk mengetahui rentang dosis pre-emptive fentanyl yang tepat serta teknik lainnya sebagai alternative untuk menurunkan insiden FIC

Kata kunci : pre-emptive fentanyl, batuk, fentanyl induce cough
Artikel Sekarang
Dipublikasi pada 01 March 2013
Penulis :
» Taufiq Agus Siswagama
» Hari Bagianto
» Ristiawan Muji Laksono
Kategori : Penelitian
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Volume V Nomor 1, Maret 2013 Cover JAI
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